The words to use
- Spending Review
- The Treasury's multi-year settlement of departmental budgets. The June 2025 review set NHS day-to-day spending in England to 2028/29, at about 3% real growth a year.
- Real terms
- Figures adjusted for inflation, so they show what money can actually buy. A cash rise can be a real-terms cut if prices rise faster.
- Productivity
- Output (care delivered, adjusted for quality) divided by inputs such as staff, equipment and supplies. Acute productivity was an estimated 5 to 6% below 2019/20 levels in 2025/26.
- Deficit support
- Extra money used to cover NHS organisations' overspends. Trusts and ICBs must break even without it by the end of 2028/29.
- Capital
- Money for things that last, such as buildings, scanners and IT, kept separate from day-to-day budgets. Darzi found a £37 billion shortfall in capital investment.
- Opportunity cost
- What you give up by spending money one way rather than another. A pound spent on new scanners is a pound not spent on community nurses, so every spending answer should name what it displaces.
